Affordability, Accessibility, and Quality of Maternal Health Care Services and Level of Satisfaction of Mothers in Rural Areas in China

Objective:This study aimed to understand the affordability,accessibility,and quality of maternal and child health services for postpartum mothers,and their impact on satisfaction.Methods:The study utilized the Anderson model and revised the Maternal Pregnancy and Perinatal Health Service Questionnaire.A survey was conducted among 289 mothers aged 20–49 in Feicheng City.Results:Regarding accessibility,most respondents(133)reported that travel time to healthcare services exceeded 60 minutes,while 99 respondents indicated a travel time of 16–30 minutes.The issue of affordability was highlighted,with 86.85%of participants perceiving maternal healthcare services as costly,indicating a significant financial burden.More than 50%of respondents were satisfied with two specific dimensions(P<0.05)regarding the quality of maternal healthcare services.Conclusion:The study found that accessibility,affordability,and quality significantly affect mothers’satisfaction with maternal health services.Future research should focus on developing more suitable service pathways for rural mothers.

Availability, Prices and Affordability of Glaucoma Medicines among Private Pharmacies of Nampula City in Mozambique

Introduction: Glaucoma is a group of chronically progressive disorders of the optic nerve and a worldwide leading cause of irreversible vision loss. Eye chronic diseases including glaucoma are major public health problems around the world, rapidly increasing with a growing and aging population. The treatment of chronic diseases lasts a lifetime. The purpose of this study is to assess the availability, prices and affordability of the medicines for glaucoma management in private pharmacies of Nampula City in Mozambique. Material and Methods: The standardized methodology designed by the World Health Organization and Health Action International was employed to conduct the study about the availability, price and affordability of glaucoma medicines in Nampula City from October to November 2021. Data were collected in 39 private pharmacies using a survey with fifteen glaucoma Medicines. Results: The Average of medicines availability was 46.6% (0.0% - 71.8%) with a mean of 8.86. The availability level demonstrated that 14 (93.3%) of all surveyed glaucoma medicines were very low and 1 (6.67%) was fairly high. Timolol was the most available medicine, found in 28 (71.8%) while apraclonidine, carteolol, levobunolol, carbachol, brinzolamide, bimatoprost, travoprost and unoprostone were not available. The medicine with the lowest price was latanoprost (2.84 USD) and the higher was acetazolamide (23.58 USD). None of the surveyed medicines were considered affordable. Conclusion: The majority of surveyed glaucoma medicines were not available and they were totally unaffordable against the defined thresholds. Policy strategy and technical options should be driven and implemented by the government to ensure the availability and affordability of glaucoma medicines at various levels of the Mozambican healthcare system.

Availability and Affordability of Therapeutic Monoclonal Antibodies After the New Medical Reform in Hubei Province,China

Objective In 2017,China launched a new round of medical reform(NMR)to address the inaccessibility of high-priced drugs for patients with serious diseases.This study explored the impact of the NMR on the accessibility and affordability of high-priced monoclonal antibodies(mAbs),and the effective promotion policies after the NMR.Methods We used a standard method developed by the World Health Organization to conduct two surveys on the availability of mAbs and their prices before and after the NMR in the public hospitals in Hubei province,China.By interviewing hospital pharmacy experts,we identified the potential value of the current NMR in improving the access to therapeutic mAbs.Results The average availability of 13 mAbs increased by 8.1%in the surveyed hospitals of Hubei province after the NMR.The median unit price of 10 mAbs dropped by 34.3%.The average affordability of a treatment cycle of 10 mAbs dropped from 680 days to 298 days of the disposable daily income for a middle-income resident(56.2%reduction).The drug price negotiation of medical insurance inclusion and the promotion of consistent evaluation of generic and original drugs could effectively promote the accessibility of mAbs.However,the zero markup of drug pricing and the limit on the proportion of drug revenues in public hospitals showed certain negative effects on the availability of mAbs.Conclusion Not all current NMR policies play a positive role in promoting the accessibility of mAbs.To further improve the accessibility of mAbs in the future in China,it is therefore critical to increase the investment in independent research and development of high-quality mAbs,establish localized guidelines for the rational use of mAbs in clinical practice,and have a cost-sharing mechanism for high-priced drugs with multiple stakeholders.

Solar PV Electrification in Nigeria: Current Status and Affordability Analysis

Rural households represent, by far, the greater percentage of dwellings globally without access to the electricity supply. For reasons of low loads, distance from the grid and speed of deployment, distributed energy systems are now considered viable options for rural electrification. This paper presents the status of solar Photovoltaic (PV) in Nigeria and discusses the way forward for aggressive PV penetration in Nigeria’s energy mix, especially in rural communities. At present, distributed PV penetration in Nigeria is comparatively low based on the International Energy Association’s recommended PV market potential. This shows that there is a gap between the government’s policy targets and reality. The solar resource potential across the six geo-political zones in Nigeria is also presented, which ranges from 3.393 - 6.669 kWh/m2/day, with the Northern zones exhibiting better potentials over the Southern zones. It is shown that the levelised cost of electricity from PV system ranges from 0.387 - 0.475 $/kWh, whereas it is 0.947 US$/kWh and 0.559 US$/kWh for the diesel generator and glass-covered kerosene lamp, respectively. While this study shows that PV for rural household lighting is more affordable as compared to glass-covered kerosene lamps and fossil-fuelled generators for lighting, fiscal and energy policies for market creation are critical if PV systems are to deliver on their promise for rural electrification and climate change mitigation.

Applications of Housing Affordability Measurement Approaches Used in Planning Affordable Housing: A Systematic Review

Housing affordability measurement is a recurring subject in planning literature. Research evidence suggests that in planning for affordable housing, planners typically apply the normative (ratio and residual income) measures to all variants of affordability stress. Hence, proffering intervention strategies that often fail to address peculiar situations in their towns. This systematic review synthesizes empirical evidence in the literature relating to various applications of housing affordability measurement approaches. To ascertain the various application fields/domains, present findings, specify relevant literature gaps, and propose future research themes. The review findings demonstrate that the accurateness of conclusions reached, about the severity of the housing affordability problem is highly dependent on the measurement approach used. The study concludes that the application of appropriate methods to specific situations leads to better planning outcomes.

Research on Affordability Modeling of Aircraft Based on Effectiveness Indexes

With the cost estimation of military aircraft as the research object, this paper aims to study the contradiction between the choice of explanatory variables in index modeling and the maintaining of model validity. It analyzes and establishes a cost estimation modeling concept based on an Effectiveness Index and studies the way to construct Effectiveness Indexes for the sake of cost estimation modeling. Based on a case study, the paper establishes and analyzes the Effectiveness Index-based cost estimation models and DAPCA （Development And Procurement Costs of Aircraft） models developed by the RAND Corparation . The comparison of these models shows that the Effective- ness Index-based cost parameter models not only comprehensively consider the obvious driving parameter indexes of the cost, but reduces the variables of regressive analysis, hence giving the model a higher reliability.

A Review on Housing Affordability and Housing Policy Application in Neglected Border Cities in Jordan

The main task of this paper is to examine housing affordability and housing policy application in neglected border cities in Jordan.After the Iraq war in 2003 and Syria civil war in 2011 many border cities accommodated a large number of refugees in its urban context over different periods of time.The lack of affordable housing and increase of unemployment were the main challenges for its vulnerable communities.Border cities are facing different development challenges but applying the same housing policy as metropolises.The paper studies economic attributes and social characteristics of Mafraq city to analyze housing obstacles.It concludes that houses are unaffordable in these border cities and housing policies need modifications.The paper recommended that housing affordability in border cities must include community participation and sufficient financial aid to low income families.In order to maintain houses affordable in border cities,the real estate market,community participation,urban planning and promotion for tourism are all essential.

Can nutrition interventions tackle the global insulin affordability via improving diabetes management and reducing insulin demand?

Diabetes,a global health concern,requires insulin therapy.As insulin demand and prices rise dramatically,insulin affordability has increasingly become an issue facing patients with diabetes worldwide.To cut insulin costs,many patients ration their supply,which may have dire health consequences.This particularly affects lower-income populations,who are often forced to choose between purchasing their medications or paying for other necessities.Nutrition might be one solution for this.This commentary aims to provide comprehensive insight with historical context into intersectional components of diabetes in the global arena through analyses of insulin affordability,coupled with the critical role of nutrition intervention after searching the PubMed for relevant articles.More studies in personalized nutrition,supplementations,and dietary behaviors may develop evidence-based nutrition interventions to control diabetes.We argue that alongside price regulation,a greater focus to nutrition to address issues of food insecurity and food assistance programs may help to improve insulin affordability.

Balancing medical innovation and affordability in the new healthcare ecosystem in China:Review of pharmaceutical pricing and reimbursement policies

The China Basic Medical Insurance Program was created in 1999 with three objectives:equal accessibility,affordability,and quality.Today,it has become the biggest medical insurance program in the world,covering 95%of China's population.Since 2015,China's healthcare ecosystem has been reshaped by increasing innovation,which has in turn been driven by regulatory reform,enhancement of research and development capability,and capital market development.There has also been improved regulatory efficiency to reduce lags in launching drugs.In 2022,nearly 20%of novel active substances launched globally were from China.China has also risen to become the second biggest contributor to innovation in terms of pipelines.Using a“fast-follow”strategy,many locally developed innovative drugs can compete with products from multinational companies in their quality and pricing.However,China's pharmaceutical and biotechnology industry will continue to face challenges in pricing and reimbursement,as well as a shortened product lifecycle with rapid price erosion.The government has already accelerated the timeline for updating the drug reimbursement list and is willing to create a high-quality medical insurance program.However,some obstacles are hard to overcome,including reimbursement for advanced therapies,limited funding and an increasing burden of disease due to an aging population.This article reviews the trajectory of medical innovation in China,including the challenges.Looking forward,balancing affordability and innovation will be critical for China to continue the trajectory of growth.The article also offers some suggestions for future policy reform,including optimizing reimbursement efficiency with a focus on highquality solutions,enhancing the value assessment framework,payer repositioning from“value buyer”to“strategic buyer”,and developing alternative market access pathways for innovative drugs.

Treatment of coronavirus disease 2019 in Shandong,China:a cost and affordability analysis

Background:Coronavirus disease 2019(COVID-19)is now a global public threat.Given the pandemic of COVID-19,the economic impact of COVID-19 is essential to add value to the policy-making process.We retrospectively conducted a cost and affordability analysis to determine the medical costs of COVID-19 patients in China,and also assess the factors affecting their costs.Methods:This analysis was retrospectively conducted in Shandong Provincial Chest Hospital between 24 January and 16 March 2020.The total direct medical expenditures were analyzed by cost factors.We also assessed affordability by comparing the simulated out-of-pocket expenditure of COVID-19 cases relative to the per capita disposable income.Differences between groups were tested by student t test and Mann-Whitney test when appropriate.A multiple logistic regression model was built to determine the risk factors associated with high cost.Results:A total of 70 COVID-19 patients were included in the analysis.The overall mean cost was USD 6827 per treated episode.The highest mean cost was observed in drug acquisition,accounting for 45.1%of the overall cost.Total mean cost was significantly higher in patients with pre-existing diseases compared to those without preexisting diseases.Pre-existing diseases and the advanced disease severity were strongly associated with higher cost.Around USD 0.49 billion were expected for clinical manage of COVID-19 in China.Among rural households,the proportions of health insurance coverage should be increased to 70%for severe cases,and 80%for critically ill cases to avoid catastrophic health expenditure.Conclusions:Our data demonstrate that clinical management of COVID-19 patients incurs a great financial burden to national health insurance.The cost for drug acquisition is the major contributor to the medical cost,whereas the risk factors for higher cost are pre-existing diseases and severity of COVID-19.Improvement of insurance coverage will need to address the barriers of rural patients to avoid the occurrence of catastrophic health expenditure.

A Review of Rechargeable Zinc-Air Batteries:Recent Progress and Future Perspectives

Zinc-air batteries(ZABs)are gaining attention as an ideal option for various applications requiring high-capacity batteries,such as portable electronics,electric vehicles,and renewable energy storage.ZABs offer advantages such as low environmental impact,enhanced safety compared to Li-ion batteries,and cost-effectiveness due to the abundance of zinc.However,early research faced challenges due to parasitic reactions at the zinc anode and slow oxygen redox kinetics.Recent advancements in restructuring the anode,utilizing alternative electrolytes,and developing bifunctional oxygen catalysts have significantly improved ZABs.Scientists have achieved battery reversibility over thousands of cycles,introduced new electrolytes,and achieved energy efficiency records surpassing 70%.Despite these achievements,there are challenges related to lower power density,shorter lifespan,and air electrode corrosion leading to performance degradation.This review paper discusses different battery configurations,and reaction mechanisms for electrically and mechanically rechargeable ZABs,and proposes remedies to enhance overall battery performance.The paper also explores recent advancements,applications,and the future prospects of electrically/mechanically rechargeable ZABs.

“示能”(Affordance)概念的演化——诺曼设计心理学理论中的Affordance词用考析

具有实用主义特质的设计心理学与强调个体生命性的生态心理学在“知觉—行动”的发生机制问题上有着根本分歧,因此,诺曼在设计领域使用吉布森所创的Affordance概念时无法完全遵照原意,而是突出追求“确定性”和“可操作性”的方法理路,Affordance概念的内涵发生了变化。在设计心理学中探索一条融合生态知觉思想的研究进路是有可能并有价值的。

基于计算机视觉的Affordance理解研究综述

利用基于计算机视觉的Affordance理解研究行为者和周围环境之间的交互属性,对指导机器人导航、抓取具有重要意义。因此,全面、深入地综述了基于计算机视觉的Affordance理解研究现状。首先,对近年来提出的方法依据研究方向进行归类,综述不同方法的思路和特点;然后,对多个常用的公开数据集进行介绍,并对不同方法在这些数据集上的性能进行对比分析;最后,阐述基于计算机视觉的Affordance理解各类方法的优势与不足及未来的发展趋势。

Energy Blockchain in Smart Communities: Towards Affordable Clean Energy Supply for the Built Environment

The rapid growth of distributed renewable energy penetration is promoting the evolution of the energy system toward decentralization and decentralized and digitized smart grids.This study was based on energy blockchain,and developed a dual-biding mechanism based on the real-time energy surplus and demand in the local smart grid,which is expected to enable reliable,affordable,and clean energy supply in smart communities.In the proposed system,economic benefits could be achieved by replacing fossil-fuel-based electricity with the high penetration of affordable solar PV electricity.The reduction of energy surplus realized by distributed energy production and P2P energy trading,within the smart grid results in less transmission loss and lower requirements for costly upgrading of existing grids.By adopting energy blockchain and smart contract technologies,energy secure trading with a low risk of privacy leakage could be accommodated.The prototype is examined through a case study,and the feasibility and efficiency of the proposed mechanism are further validated by scenario analysis.

IMAGE-BUILDING AND FRAMING PROCESSES OF AN ANTI-MOTHER/-WOMAN IN CICERO’S PRO CLUENTIO

In this case study we explore Cicero’s processes of framing and image-building regarding the concept of an anti-mother/-woman.For this we examine Cicero’s portrayal of Sassia,a woman who features as one of the main antagonists of his speech Pro Cluentio.We analyse Cicero’s depiction of Sassia’s evilness towards her son,Cluentius,through the lens of frame and framing theories.By doing so,this case study aims to present a deeper understanding of Cicero’s stratagems(e.g.,priming,calling for action;nudging,pushing someone towards action;and affordance,offering a frame to act outside of or within)which were employed in order to devise a negative characterisation of Sassia.The application of this methodological approach to Cicero’s framing of Sassia provides a new scope for analysing not only the classical text itself but also for the analysis of ancient human society to which it belonged.

Living in a Condominium Regime:Neighborhood Conflicts in Low-Income Housing,Tijuana,Baja California-A Secondary Publication

This paper analyzes neighborhood conflicts arising from the condominium property regime,under which social housing promoted by Mexican government institutions and private developers is acquired.This regime has facilitated access to housing for the salaried population,but it is far from contributing to the attainment of the right to housing.The research takes as case studies housing complexes located in the city of Tijuana,Baja California,Mexico.The analysis included a mixed methodology.Firstly,similar case studies were analyzed;secondly,a review of the Condominium Property Regime Law was carried out in order to understand its implications.In view of the pandemic situation,a virtual survey was applied to the inhabitants of these areas,as well as interviews with presidents of neighborhood committees of these complexes.From the above,it was found that this form of ownership generates conflicts,reflected in the dissatisfaction of the inhabitants with their housing,disagreements and controversies in their organization and coexistence.The inhabitants have to collectively solve the problems they face,related to the maintenance and use of common areas,insecurity,and cleanliness,among others.In addition,there is a lack of support from local authorities.With this,it is concluded that although the inhabitants have a space that solves their housing problem,it does not manage to be a space that adequately guarantees their right to housing.

No Pain, All Gain

Chinese doctors in Rwanda revolutionise childbirth by making painless deliveries affordable In a move that could transform childbirth procedures in Rwanda,Chinese doctors at the Masaka District Hospital in Kicukiro have successfully facilitated natural birth by a woman living with HIV.This milestone marks a significant step towards safer and more accessible childbirth practices in the country.

The Optimization Path of Research Support Services in University Libraries from the Perspective of Affordance Theory

University libraries,as an integral component of university research capabilities,are tasked with serving education by providing research support to faculty and students.This study adopts an affordance research perspective originating from ecological psychology to explore the optimization path of research support services in libraries in the new media era.Based on the characteristics of university library services,this research analyzes three aspects:production affordance,mobile affordance,and social affordance,and proposes practical recommendations to guide future research service practices of university libraries.

从设计心理学看情感产品开发设计

从社会生产力和经济发展指出情感化产品设计是未来设计发展的必然趋势,再由人类心理行为切入,介绍了国外设计心理学Affordance概念的发展状况和其重要原因以及对产品设计未来的启发,最后结合Affordance对日本新奇情感娱乐产品putiputi无限挤泡泡纸进行深入剖析,分析其成功因素、开发过程、产品形态语义,尝试从中得到在情感需求产品的开发方法。

Affordance认知探究及其在产品设计中的应用

目的从认知理论角度探讨Affordance概念在产品设计中的应用。方法通过阐述Affordance理论在认知领域的起源及在设计领域的发展,介绍了深泽直人对Affordance的传承提出了"无意识设计"理念,进而研究Affordance在用户、产品、环境承担的作用。结论总结归纳4种运用于产品设计中的Affordance类型,并针对现有优秀产品案例探讨,详细分析Affordance是如何运作于产品设计中的。最后提出设计人员应该把握四点方向,以更好地从Affordance对产品的影响入手设计出优良的产品。。